Our goal is to help your smile stay beautiful and healthy for a lifetime. Your cooperation is essential in order to achieve this goal. The benefits of orthodontic treatment will last a lifetime if you keep these important patient responsibilities in mind:
Once the braces are removed, the patient will receive retainers to hold the dental correction. Because the bone and soft tissues surrounding the teeth are re-organizing after the braces are removed, it is imperative that the retainers are worn as instructed. Failure to wear the retainers may result in undesirable movement of the teeth, which could necessitate re-treatment. It is common that the teeth do not stay exactly where they were when the braces come off even with good retainer wear. Typically the movement that occurs after the braces are removed is very small and of little consequence or concern to patients. We are dealing with the human body however and in a very small number of cases the teeth can shift beyond what we would like even with the recommended retainer wear. That is why we strongly recommend that our patients follow our retainer wear instructions as well as our retainer follow up visit recommendations.
How retainers are worn
Since teeth can continue to move throughout life, we feel that individuals who have undergone orthodontic therapy should wear retainers at night indefinitely to hold the correction we have worked together to achieve. Our experience has been that without regular retainer wear most people’s teeth will become misaligned over time and this is true regardless of whether the wisdom teeth are present or not and regardless of whether an individual has had orthodontic treatment or not. We typically have our patients wear their retainers all the time for 3 months after the braces are removed and then at night indefinitely thereafter but that can vary depending on the needs of our individual patients.
We follow our patients with retainer check up appointments until we get to the point where we feel the stability of the teeth and our patient’s awareness of the their retainers allows them to monitor their own retainers and call us if there are any questions or problems. For our teens we will typically take a panoramic x-ray at some point in the later teen years to check the position of, and make recommendations on, the wisdom teeth.
How to care for retainers
- Retainers are made of a thermoplastic material that is sensitive to excessive heat, so they should be kept away from heaters, dishwashers, washers, dryers, car dashboards, sunny window sills or any place where the temperatures exceed 115 degrees (Fº).
- Retainers should be kept in the proper retainer case when they are not in the patient’s mouth otherwise there is a good chance they will be lost or broken.
- Keep retainers away from any family pets, as they like to chew on them.
- Clean before and after placement in the mouth. Because the material used for fabrication is slightly porous, plaque tends to cling to the surfaces. Gentle scrubbing with a toothbrush and a mild liquid soap will remove the plaque. A denture cleaning solution, such as Efferdent, or a retainer cleaning solution such as Retainer Brite, will aid in the removal of plaque. Be sure to rinse the retainers thoroughly after cleaning to remove any cleanser residue.
- If hard tarter deposits form on your retainers, they can be placed for 10 minutes in small ultrasonic cleaner, which can be purchased over the internet, in a solution of white vinegar and then scrubbed with a stiff brush to knock off the deposits. Rinse the retainers thoroughly after cleaning to remove solution.
- If retainers need to be sterilized they should not be put in hot or boiling water. They can be soaked in a solution of 1:10 bleach to water for 15 minutes and then thoroughly rinsed with water.
Because retainers are worn for years, they will break at some point and need replacement. Your original treatment contract includes one set of retainers after the braces are removed. If the retainers are lost or damaged, or break over time there will be a charge for replacement. If the retainers become loose, break, don’t fit well or anything seems unusual contact our office immediately.
Fixed retainers (Bonded Wire)
This wire should stay on forever. The only exception is if your family dentist says you are not keeping it clean and it is beginning to cause gum or bone problems. If this should occur, please have the wire removed and replace it with a removable retainer. If there is no retainer present the teeth will likely become misaligned regardless of how long it has been since the braces were removed. The removable retainer should then be worn as Drs. Iezman and Osterman prescribe. Fixed retainer wires are cemented to the teeth and over time it is common for some of the cement bonds to fail and need to be replaced. For this reason, and to check the health of the gums and bone around the fixed wire it is very important you have this wire monitored by your family dentist at your six-month check ups when you are no longer seeing us for retainer check up appointments.
Habits or Conditions
Even when patients follow our retainer wear instructions there are some habits and conditions that may still result in undesirable changes after the braces are removed. Some of these are clenching and/or grinding of the teeth (muscle hyperactivity), tongue thrusting, low tongue posture or abnormal tongue posture, thumb and finger habits, late underbite jaw growth and instability of the jaw joint. In these cases further treatment may be recommended or desired even with good retainer wear.
Dental examinations and cleanings
Orthodontic treatment is only one part of overall dental health. It is very important that our patients continue with proper oral hygiene procedures at home, to include thorough brushing and flossing techniques and continue to see their family dentist at the recommended intervals, but no less than every six months, for cleanings and dental examinations.